新发麻风712例临床分析

The clinical analysis of 712 newly detected leprosy cases

目的：分析近年来江西省新发麻风病例临床特征，提高临床诊断和治疗麻风病水平。方法根据2000～2012年江西省新发麻风资料进行回顾性分析。结果新发麻风病患者712例，男女比2.72∶1，农民占87.36%，有家族史者占32.44%。发现方式以皮肤科门诊为主，占71.63%；平均病程（延迟期）（31.12±8.14）个月。误诊情况：首诊确诊者318例（44.66%），误诊次数平均达（5.34±3.19）次。临床表现上仅有皮损者15.87%，仅有神经损害者13.62%，两者兼有者64.47%。临床分型TT10.39%，BT17.98%，BB8.57%，BL30.17%，LL31.46，I1.4%；不同类型查菌阳性率有较大差别；大都具有麻风病的特征病理表现。患者均给予联合化疗，出现麻风反应162例次，神经炎186例次；临床判愈698例，非治疗死亡11例，治疗死亡3例，残疾比为25.98%。结论江西省麻风病处低流行状态。确诊麻风需要以皮肤科临床为主，结合查菌和病理结果。治疗中需注意药物的副作用及麻风反应和神经炎等并发症。

Objective To analyze the clinical features of new leprosy cases in Jiangxi in recent years and improve the level of clinical diagnosis and treatment of leprosy. Methods A retrospective analysis was made according to the data of new leprosy cases in Jiangxi during 2000-2012. Results There were 712 new leprosy patients with a sex ratio 2.72∶1,among whom peasants account for 87.36%,and the patients with family history account for 32.44%. The founding ways give priority to dermatology clinics ,which account for 71.63%. The average duration was 31.12±8.14 months. There were 318 leprosy cases that can be confirmed at the first diagnosis,and the average misdiagnosis times were 5.34±3.19. Through the clinical manifestations,patients only with skin lesions account for 15.87%,patients only with nervous lesion account for 13.62%,and patients with both skin lesions and nervous lesion account for 64.47%. The clinical types contains TT10.39%,BT17.98%,BB8.57%,BL30.17%,LL31.46%,I1.4%. There were big differences in checking the fungus’s positive rate,and most of the patients have leprosy pathological manifestations. The patients were treated by combined chemotherapy,with a leprosy reaction in 162 cases and neuritis in 186 cases. 698 cases were clinically cured,11 cases died not for the treatment,3 cases died for the treatment,and the disability accounted for 25.98%. Conclusion Leprosy is not popular in Jiangxi. The diagnosis of leprosy needs to give priority to dermatology clinics ,combining with checking the fungus and pathological results. The attention should be paid to the side effects of drugs and the complications such as leprosy reaction and nerve inflammation during the treatment.